1. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 18-1 Chapter 18 Obstetrics Through Chiropractic Sections (0–9)

2. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Learning Objectives LO 18.1 Recognize the details reported in sections of ICD-10-PCS other than the Medical and Surgical section. LO 18.2 Evaluate the details to determine the section from which to code. LO 18.3 Determine the body system or region being treated. 18-2

3. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Learning Objectives (cont.) LO 18.4 Interpret the procedure to determine the accurate root operation term. LO 18.5 Utilize knowledge of anatomy to determine the body part treated. LO 18.6 Identify the approach used to access the body part. 18-3

4. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Learning Objectives (cont.) LO 18.7 Distinguish the type of device implanted or other qualifier, when applicable. LO 18.8 Select the appropriate qualifier character. 18-4

5. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Key Terms Abortifacient Extracorporeal Laminaria Products of conception Somatic 18-5

6. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. ICD-10-PCS Sections Obstetrics (1) Osteopathic (7) Other Procedures (8) Chiropractics (9) Placement (2) 18-6

7. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. ICD-10-PCS Sections (cont.) Administration (3) Measurement and Monitoring (4) Extracorporeal Assistance and Performance (5) Extracorporeal Therapies (6) 18-7

8. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Definitions 18-8

9. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 1: Obstetrics Section 1 All of the codes reporting an obstetrics procedure will begin with the number one (1) The timeline of gestation (gestational age or trimester) is not relevant to reporting procedures 18-9

10. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 2: Body System: 0–9, B–Y Only one body system in obstetrics –0 Pregnancy 18-10

11. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 3: Root Operation 10 root operation terms –Abortion: Artificially terminating a pregnancy... Character: A –Change: Taking out or off a device from a body part and putting back an identical or similar device in or on the same body part without cutting or puncturing the skin or a mucous membrane... Character: 2 18-11

12. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 3: Root Operation 10 root operation terms (cont.) –Delivery: Assisting the passage of the products of conception from the genital canal... Character E –Drainage: Taking or letting out fluids and/or gases from a body part...Character 9 18-12

13. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 3: Root Operation (cont.) 10 root operation terms (cont.) –Extraction: Pulling or stripping out or off all or a portion of a body part by the use of force... Character D –Insertion: Putting in nonbiological appliance that monitors, assists, performs, or prevents a physiological function but does not physically take the place of a body part... Character H 18-13

14. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 3: Root Operation (cont.) 10 root operation terms (cont.) –Inspection: Visually and/or manually exploring a body part... Character J –Removal: Taking out or off a device from a body part... Character P 18-14

15. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 3: Root Operation (cont.) 10 root operation terms (cont.) –Repair: Restoring, to the extent possible, a body part to its normal anatomic structure and function... Character Q –Reposition: Moving to its normal location or other suitable location all or a portion of a body part... Character S 18-15

16. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 3: Root Operation (cont.) 10 root operation terms (cont.) –Resection: Cutting out or off, without replacement, all of a body part...Character T –Transplantation: Putting in or on all or a portion of a living body part taken from another individual or animal to physically take the place and/or function of all or a portion of a similar body part... Character Y 18-16

17. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 4: Body Part: 0–9, B–Y Obstetrics section focuses on three body parts –Products of conception... Character 0 (zero) –Products of conception, retained... Character 1 –Products of conception, ectopic... Character 2 18-17

18. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 5: Approach Open: Cutting through the skin or mucous membrane and any other body layers necessary to expose the site of the procedure... Character 0 18-18

19. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 5: Approach (cont.) Percutaneous: Entry, by puncture or minor incision, of instrumentation through the skin or mucous membrane and any other body layers necessary to reach the site of the procedure... Character 3 18-19

20. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 5: Approach (cont.) Percutaneous Endoscopic: Entry, by puncture or minor incision, of instrumentation through the skin or mucous membrane and any other body layers necessary to reach and visualize the site of the procedure... Character 4 18-20

21. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 5: Approach (cont.) Via Natural or Artificial Opening: Entry of instrumentation through a natural or artificial external opening to reach the site of the procedure... Character 7 18-21

22. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 5: Approach (cont.) Via Natural or Artificial Opening Endoscopic: Entry of instrumentation through a natural or artificial external opening to reach and visualize the site of the procedure... Character 8 18-22

23. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 5: Approach (cont.) External: Procedure performed directly on the skin or mucous membrane and procedures performed indirectly by the application of external force through the skin or mucous membrane... Character X 18-23

24. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 6: Device Sixth position will identify a device that will remain with the patient after the procedure has been completed –Fetal monitoring electrodes –Monitoring Electrode... Character 3 –Other Device... Character Y –No Device... Character Z 18-24

25. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 7: Qualifier Required There may be no more details to add –Use the placeholder letter Z No Qualifier—the equivalent of “not applicable.” 18-25

26. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 7: Qualifier (cont.) If the physician uses forceps or other assisting mechanism, this delivery becomes an extraction –Low forceps... Character 3 –Mid forceps... Character 4 –High forceps... Character 5 –Vacuum... Character 6 –Internal version... Character 7 –Other... Character 8 18-26

27. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 7: Qualifier (cont.) Cesarean delivery –Classical (c-section incision)... Character 0 –Low Cervical... Character 1 –Extraperitoneal... Character 2 18-27

28. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 7: Qualifier (cont.) Amniocentesis –Fetal blood... Character 9 –Fetal cerebrospinal fluid... Character A –Fetal fluid, other... Character B –Amniotic fluid, therapeutic... Character C –Fluid, other... Character D –Amniotic fluid, diagnostic... Character U 18-28

29. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 7: Qualifier (cont.) Artificial termination of a pregnancy (abortion) –Vacuum... Character 6 –Laminaria... Character W –Abortifacient... Character X 18-29

30. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 7: Qualifier (cont.) In utero procedure performed on the fetus –Nervous system... E –Hepatobiliary and pancreas... N –Cardiovascular system... F –Endocrine system... P –Lymphatics and hemic... G –Skin... Q 18-30

31. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 7: Qualifier (cont.) In utero procedure performed on the fetus (cont.) –Eye... H –Musculoskeletal system... R –Ear, nose, and sinus... J –Urinary system... S –Respiratory system... K 18-31

32. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 7: Qualifier (cont.) In utero procedure performed on the fetus (cont.) –Female reproductive system... T –Mouth and throat... L –Male reproductive system... V –Gastrointestinal system... M –Other body system... Y 18-32

33. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Definitions: Placement Section 18-33

34. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 1: Placement Section 2 Report the locating of a device either in or on a body region for protection, immobilization, stretching, compression, or packing 18-34

35. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 2: Body System Two body system options: –Anatomical Regions... Character W –Anatomical Orifices... Character Y 18-35

36. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 3: Root Operation Placement Section Only report procedures that are noninvasive Change: Taking out or off a device from a body part and putting back an identical or similar device in or on the same body part without cutting or puncturing the skin or a mucous membrane... Character: 0 18-36

37. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 3: Root Operation Placement Section (cont.) Compression: Putting pressure on a body region... Character 1 Dressing: Putting material on a body region for protection... Character 2 18-37

38. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 3: Root Operation Placement Section (cont.) Immobilization: Limiting or preventing motion of an external body region... Character 3 Packing: Putting material in a body region or orifice... Character 4 18-38

39. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 3: Root Operation Placement Section (cont.) Removal: Taking out or off a device from a body part... Character 5 Traction: Exerting a pulling force on a body region in a distal direction... Character 6 18-39

40. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 4: Body Region Anatomical Regions –Head... Character 0 –Hand, Left... F –Face... 1 –Thumb, Right... G –Neck... 2 –Thumb, Left... H 18-40

41. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 4: Body Region Anatomical Regions (cont.) –Abdominal Wall... 3 –Finger, Right... J –Chest Wall... 4 –Finger, Left... K –Back... 5 –Lower Extremity, Right... L 18-41

42. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 4: Body Region (cont.) Anatomical Regions (cont.) –Inguinal Region, Right... 6 –Lower Extremity, Left... M –Inguinal Region, Left... 7 –Upper Leg, Right... N –Upper Extremity, Right... 8 –Upper Leg, Left... P 18-42

43. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 4: Body Region (cont.) Anatomical Regions (cont.) –Upper Extremity, Left... 9 –Lower Leg, Right... Q –Upper Arm, Right... A –Lower Leg, Left... R –Upper Arm, Left... B –Foot, Right... S 18-43

44. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 4: Body Region (cont.) Anatomical Regions (cont.) –Lower Arm, Right... C –Foot, Left... T –Lower Arm, Left... D –Toe, Right... U –Hand, Right... E –Toe, Left... V 18-44

45. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 4: Body Region (cont.) Anatomical Orifices –Mouth and Pharynx... 0 –Nasal... 1 –Ear... 2 –Anorectal... 3 –Female Genital Tract... 4 –Urethra... 5 18-45

46. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 5: Approach All procedures reported from the Placement section do not involve incisions or punctures External approach... Character X 18-46

47. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 6: Device Placement of a device –Traction apparatus... Character 0 –Splint... Character 1 –Cast... Character 2 –Brace... Character 3 –Bandage... Character 4 –Packing Material... Character 5 18-47

48. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 6: Device (cont.) Placement of a device (cont.) –Pressure Dressing... Character 6 –Intermittent Pressure Device... Character 7 –Wire... Character 9 –Other Device... Character Y –No device... Character Z 18-48

49. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 7: Qualifier No Qualifier... Character Z is the only option 18-49

50. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Administration Section Character Definitions 18-50

51. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 1: Administration Section 3 Procedures reported from the Administration section will all begin with the number 3 18-51

52. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 2: Physiology System Only three options –Circulatory... Character 0 (This is used for transfusion procedures.) –Indwelling device... Character C –Physiological Systems and Anatomical Regions... Character E 18-52

53. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 3: Root Operation Three root operation terms –Introduction: Putting in or on a therapeutic, diagnostic, nutritional, physiological, or prophylactic substance except blood or blood products... Character 0 –Irrigation: Putting in or on a cleansing substance... Character 1 –Transfusion: Putting in blood or blood products... Character 2 18-53

54. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 4: Body System/Region Will report the anatomical site into which the substance is administered 18-54

55. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 5: Approach Open (0) Percutaneous (3) Via Natural or Artificial Opening (7) Via Natural or Artificial Opening Endoscopic (8) External (X) 18-55

56. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 6: Substance Identifies the substance being administered 18-56

57. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 7: Qualifier This character will provide additional detail about the substance, if necessary Example: –Autologous... Character 0 –Nonautologous... 1 –Oxazolidinones... 8 –No Qualifier... Z 18-57

58. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Measurement and Monitoring Section Character Definitions 18-58

59. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 1: Measurement and Monitoring Section 4 Procedures reported from this section all begin with the number 4 18-59

60. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 2: Physiology System Two options for the second character –Physiological Systems... Character A –Physiological Devices... Character B 18-60

61. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 3: Root Operation Two root operation terms –Measurement: Determining the level of a physiological or physical function at a point in time... Character 0 –Monitoring: Determining the level of a physiological or physical function repetitively over a period of time... Character 1 18-61

62. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 4: Body System/Region Includes measurement or monitoring of a patient’s metabolism, temperature, or sleep Reported with a body system of Z None 18-62

63. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 5: Approach Open (0) Percutaneous (3) Percutaneous Endoscopic (4) Via Natural or Artificial Opening (7) Via Natural or Artificial Opening Endoscopic (8) External (X) 18-63

64. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 6: Function/Device Will identify the specific body function being measured or monitored 18-64

65. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 7: Qualifier Will provide additional detail about either the body part or system or the procedure performed 18-65

66. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Extracorporeal Assistance and Performance Section Character Definitions 18-66

67. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 1: Extracorporeal Assistance and Performance Section 5 Procedures reported from this section will all begin with the number 5 18-67

68. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 2: Physiology System One option for the second character –Physiological Systems... Character A 18-68

69. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 3: Root Operation Three root operation terms –Assistance: Taking over a portion of a physiological function by extracorporeal means.. Character 0 –Performance: Completely taking over a physiological function by extracorporeal means.. Character 1 –Restoration: Returning, or attempting to return, a physiological function to its original state by extracorporeal means... Character 2 18-69

70. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 4: Body System/Region Cardiac system... Character 2 Circulatory system... Character 5 Respiratory system... Character 9 Biliary system... Character C Urinary system... Character D 18-70

71. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 5: Duration Will report the length of time, or the number of times, the patient received this treatment –Single... Character 0 (one time or one session) –Intermittent... 1 (occasionally) –Continuous... 2 (nonstop ongoing) –Less than 24 consecutive hours... 3 (nonstop for a period of time) 18-71

72. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 5: Duration (cont.) Will report the length of time, or the number of times, the patient received this treatment (cont.) –24–96 consecutive hours... 4 (nonstop for a period of time) –Greater than 96 consecutive hours... 5 (nonstop for a period of time) –Multiple... 6 (more than one time or one session) 18-72

73. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 6: Function Filtration... Character 0 Output... Character 1 Oxygenation... Character 2 Pacing... Character 3 Rhythm... Character 4 Ventilation... Character 5 18-73

74. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 7: Qualifier Balloon pump... Character 0 Hyperbaric... Character 1 Manual... Character 2 Membrane... Character 3 Nonmechanical... Character 4 Pulsatile compression... Character 5 18-74

75. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 7: Qualifier (cont.) Other pump... Character 6 Continuous Positive Airway Pressure (CPAP)... Character 7 Intermittent Positive Airway Pressure (IPAP)... Character 8 Continuous Negative Airway Pressure (CNAP)... Character 9 18-75

76. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 7: Qualifier (cont.) Intermittent Negative Airway Pressure (INAP)... Character B Supersaturated... Character C Impeller Pump... Character D No Qualifier... Character Z 18-76

77. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Extracorporeal Therapies Section Character Definitions 18-77

78. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 1: Extracorporeal Therapies Section 6 Procedures reported from this section will all begin with the number 6 18-78

79. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 2: Physiology Systems One option for the second character –Physiological Systems... Character A 18-79

80. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 3: Root Operation 10 root operation terms –Atmospheric Control: Extracorporeal control of atmospheric pressure and composition... Character 0 –Decompression: Extracorporeal elimination of undissolved gas from body fluids... Character 1 18-80

81. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 3: Root Operation (cont.) 10 root operation terms (cont.) –Electromagnetic Therapy: Extracorporeal treatment by electromagnetic rays...Character 2 –Hyperthermia: Extracorporeal raising of body temperature...Character 3 18-81

82. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 3: Root Operation (cont.) 10 root operation terms (cont.) –Hypothermia: Extracorporeal lowering of body temperature...Character 4 –Pheresis: Extracorporeal separation of blood products... Character 5 18-82

83. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 3: Root Operation (cont.) 10 root operation terms (cont.) –Phototherapy: Extracorporeal treatment by light rays... Character 6 –Shock Wave Therapy: Extracorporeal treatment by shock waves...Character 9 18-83

84. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 3: Root Operation (cont.) 10 root operation terms (cont.) –Ultrasound Therapy: Extracorporeal treatment by ultrasound...Character 7 –Ultraviolet Light Therapy: Extracorporeal treatment by ultraviolet light... Character 8 18-84

85. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 4: Body System Skin... Character 0 Urinary... Character 1 Central nervous... Character 2 Musculoskeletal... Character 3 Circulatory... Character 5 None... Character Z 18-85

86. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 5: Duration Will report the length of time, or the number of times, the patient received this treatment –Single... Character 0 (one time or one session) –Multiple... Character 1 (more than one time or one session) 18-86

87. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 6: Qualifier The only option is No Z 18-87

88. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 7: Qualifier Pheresis –Erythrocytes... Character 0 –Leukocytes... Character 1 –Platelets... Character 2 –Plasma... Character 3 –Stem Cells, Cord Blood... Character T –Stem Cells, Hematopoietic... Character V 18-88

89. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 7: Qualifier (cont.) Ultrasound –Head and Neck Vessels... Character 4 –Heart... Character 5 –Peripheral Vessels... Character 6 –Other Vessels... Character 7 –No Qualifier... Character Z All other root operation terms have no qualifier Z 18-89

90. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Definitions Osteopathic Section 18-90

91. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 1: Osteopathic Section 7 Procedures reported from this section will all begin with the number 7 18-91

92. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 2: Physiology System One option for the second character –Anatomical Regions... Character W 18-92

93. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 3: Root Operation Treatment: Manual treatment to eliminate or alleviate somatic dysfunction and related disorders... Character 0 18-93

94. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 4: Body Region Body regions supported by this section –Head... Character 0 –Lower extremities... 6 –Cervical... 1 –Upper extremities... 7 –Thoracic... 2 18-94

95. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 4: Body Region (cont.) Body regions supported by this section (cont.) –Rib cage... 8 –Lumbar... 3 –Abdomen... 9 –Sacrum... 4 –Pelvis... 5 18-95

96. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 5: Approach All osteopathic services use an external approach, reported with character X 18-96

97. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 6: Method Articulatory—raising... Character 0 Facial release... Character 1 General mobilization... Character 2 High velocity–low amplitude... Character 3 Indirect... Character 4 18-97

98. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 6: Method (cont.) Low velocity–high amplitude... Character 5 Lymphatic pump... Character 6 Muscle energy—isometric... Character 7 Muscle energy—isotonic... Character 8 Other method... Character 9 18-98

99. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 7: Qualifier No options for this character in this section –No Qualifier... Z 18-99

100. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Other Procedures Section Character Definitions 18-100

101. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 1: Other Procedures Section 8 Procedures reported from this section all begin with the number 8 18-101

102. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 2: Physiology System Only two options for the second character –Indwelling device... Character C –Physiological Systems and Anatomical Regions... Character E 18-102

103. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 3: Root Operation Other Procedures: Methodologies that attempt to remediate or cure a disorder or disease... Character 0 18-103

104. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 4: Body Region There are several body regions represented in this section – Examples: –Nervous System... Character 1 –Circulatory System... Character 2 –Head and Neck Region... Character 9 –Integumentary System and Breast... Character H –Lower Extremity... Character Y 18-104

105. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 5: Approach Open (0) Percutaneous (3) Percutaneous Endoscopic (4) Via Natural or Artificial Opening (7) Via Natural or Artificial Opening Endoscopic (8) External (X) 18-105

106. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 6: Method Acupuncture... Character 0 Therapeutic Massage... Character 1 Collection... Character 6 Computer Assisted Procedure... Character B 18-106

107. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 6: Method (cont.) Robotic Assisted Procedure... Character C Near Infrared Spectroscopy... Character D Other Method... Character Y 18-107

108. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 7: Qualifier The qualifier will provide additional details as available or necessary 18-108

109. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Definitions Chiropractic Section 18-109

110. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 1: Chiropractic Section 9 Procedures reported from this section will all begin with the number 9 18-110

111. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 2: Anatomical Regions Anatomical Regions... Character W 18-111

112. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 3: Root Operation Manipulation: Manual procedure that involves a directed thrust to move a joint past the physiological range of motion, without exceeding the anatomical limit... Character B 18-112

113. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 4: Body Region Head... Character 0 Lower extremities... 6 Cervical... 1 Upper extremities... 7 Thoracic... 2 18-113

114. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 4: Body Region (cont.) Rib cage... 8 Lumbar... 3 Abdomen... 9 Sacrum... 4 Pelvis... 5 18-114

115. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 5: Approach All services use an external approach, reported with Character X 18-115

116. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 6: Method Non-manual... Character B Indirect Visceral... Character C Extra-Articular... Character D Direct Visceral... Character F Long Lever Specific Contact... Character G 18-116

117. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 6: Method (cont.) Short Lever Specific Contact... Character H Long and Short Lever Specific Contact... Character J Mechanically Assisted... Character K Other Method... Character L 18-117

118. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Character Position 7: Qualifier Chiropractic Section There are no options for this character in the Chiropractic section –No Qualifier... Z 18-118

119. Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Chapter Summary Each character position is important to reporting all of the pertinent details of a procedure, service, or treatment. The same character can have a different meaning in each section. The tables provide the options and their meanings to build the accurate code. 18-119